Physicians Practice - January 2008 - (Page 71)

Attorney Martin-Norcross agrees. When doctors or managers tell her they don’t have time to write up performance memos, she tells them that such documentation needn’t be complex. “It could be notes on a calendar,” Martin-Norcross says. “For example, ‘I spoke to Mary today about her coming in late.’ … You just need some contemporaneous documentation of such events in case you need to justify future actions.” THE VERBAL WARNING Before you get to termination, experts generally agree that you should go through the steps of what Levoy has labeled, “progressive discipline,” a process of explaining deﬁciencies, providing an opportunity to improve, and clearly communicating the consequences of continued underperformance to an employee. Rule No. 1, says Levoy, is to “tell the employee what the problem is.” Most managers call this ﬁrst step a “verbal warning.” “Employees are often in the dark about performance-related issues,” says Levoy. “They don’t know that their attitude or certain things they are doing or aren’t doing are problematic. Nobody ever mentioned it.” Severino says that when she ﬁrst talks to an employee about performance or attitude problems, she solicits their point of view regarding the situation. Miscommunication can lead to an employee’s misunderstanding regarding your expectations of him. So Severino says she tries to make her expectations “abundantly clear,” and then she sets a timeline for compliance and schedules a follow-up meeting. “That’s a wake-up point for some people,” she says. Paula Comm, the administrator of a seven-doctor psychiatric practice near Chicago, says that she takes written notes of her “verbal” warnings, and then asks the employee with which she has spoken to indicate his understanding of the conversation by signing the note. Comm includes language that spells out the subsequent steps she will take if an employee does not WWW.PHYSICIANSPRACTICE.COM improve, which is usually a written warning and ultimately termination if the employee continues to fail to meet explicit expectations. “I’m very big on documentation so there are no big surprises during reviews,” says Comm. “I think that’s where a lot of managers make mistakes. They assume that their employees understand what is expected of them without spelling it out.” Jamison says that verbal warnings should be used as opportunities to invite employees’ opinions on their own performance or to elicit their side of the story should the warning be in response to a speciﬁc event. “Ninety percent of employees do want to do better,” he says. “They don’t want to have surprises.” That’s why many human resources departments are deciding that annual performance reviews are inadequate when dealing with an underperformer. “Reprimanding an employee for an event that happened six or nine months ago … just doesn’t cut it any more,” adds Jamison. “Bringing to their attention these events as they happen is the way to go.” But what if a verbal warning isn’t sufﬁcient? WRITE IT DOWN Comm cites as an example a receptionist she was very concerned about who seemed to be overwhelmed and unable to grasp the ofﬁce’s policies and procedures even after several interventional meetings. But once Comm dismissed an employee with whom the receptionist worked, her performance improved. “She couldn’t handle [working with] that employee,” says Comm. “So part of her lack of performance was due to the fact that she was doing her job and this other person’s job as well. Once that dynamic changed, and she was able to build conﬁdence and have someone actually help her so she wasn’t so overwhelmed, she did a 180 turnaround.” Today, a year and half later, Comm says she is “ﬂourishing.” Weida emphasizes the importance of a consistent approach if employees reach this stage. While some managers will give a second written warning before termination and others will not, what matters most is that you do everything within your power to ensure the employee in question understands the problem, your expectations for improvement, and the timeline she has until the next step is taken. And such a step should be spelled out, says Levoy. “Employees need to understand the consequences of inaction,” he says. “Generic, In most cases, the next step is a “written warning.” Like a verbal warning, written warnings should take the form of one-on-one conversations in which the employee is made aware of the situation and is again given speciﬁc goals, measurements, and timelines. “With a written warning, I usually will attach something like a copy of the practice’s policies and procedures that were not adhered to,” says Becker. “In cases in which an employee has jeopardized someone’s privacy, I will go over HIPAA regs with them and also include that in their ﬁle.” A written warning doesn’t always imply that an employee will ultimately be terminated. For some, job expectations and rules need to be spelled out again in writing. READ MORE ABOUT IT! Visit PhysiciansPractice.com for more advice on disciplining and terminating unsatisfactory employees: • Get legal advice on how to best protect your practice from subsequent lawsuits by typing “More Legal Protection” in our Search Articles box. breaches before they occur by downloading our employee “Confidentiality Agreement” in our Tools section. Performance Review” for a template on evaluating staff performance from our Tools section. • Guard against patient confidentiality • Download a sample “Staff JANUARY 2008 | PHYSICIANS PRACTICE | 71 http://PhysiciansPractice.com http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - January 2008

Physicians Practice - January 2008 Contents The Bigger Picture: Fixing Medicaid Letters Physicians Practice Pearls: You Can Teach an Old Dog New Tricks Noteworthy Cover Story: Fee Schedule Survey: 2007 Results Adding Ancillaries: Bucking the Practice Ask the Experts Idealab: 'How I Got Over My EMR Excuses' Technology: Don't Be Denied The Tech Doctor: Blessing or Curse? The Administrator's Desk: Learning From the Best Coding Career: To Partner, or Not? Management: Controlling Your Inventory Human Resources: How to Fire an Enployee Finance: Beyond Reimbursment - How to Fix Your Mix Classifieds Advertiser Index

Physicians Practice - January 2008

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